title: Diagnosis of tuberculous peritonitis using endoscopic ultrasound-guided fine-needle aspiration biopsy of the peritoneum.
abstract: OBJECTIVE
  Tuberculous peritonitis is prevalent in developing countries and its diagnosis is still challenging due to the lack of specific clinical characteristics and the difficulty in obtaining tissue from the peritoneum without laparoscopy. Endoscopic ultrasound - guided fine needle aspiration is emerging as the most effective and safe method for obtaining tissue from the structures surrounding the gut lumen. Our study aimed to elucidate the efficacy of endoscopic ultrasound-fine needle aspiration of the peritoneum in the diagnosis of tuberculous peritonitis.
  
  
  METHODS
  Three patients (2 male and 1 female; aged 38, 25, and 65 years, respectively) suspected of having tuberculous peritonitis were recruited into the study. Clinical evaluation including computed tomography imaging and analysis of ascitic fluid were performed. Endoscopic ultrasound-fine needle aspiration biopsy of the peritoneum was performed trans-gastrically with a 19-gauge ProCore needle in all patients. At least two different areas of the peritoneum suspected to be involved were sampled and paraffin-embedded cell blocks were prepared for each biopsy specimen.
  
  
  RESULTS
  Biopsy specimens were positive for Mycobacterium tuberculosis by polimerase chain reaction in 2 patients and positive for multinucleated giant cells in all patients. Treatment for tuberculosis resulted in the resolution of symptoms and ascites. No procedure- related complications occured.
  
  
  CONCLUSIONS
  Endoscopic ultrasound-fine needle aspiration is an efficacious and safe method to obtain tissue from the peritoneum to use in the diagnosis of tuberculous peritonitis.
authors.affiliation: Department of Gastroenterology, Bezmialem University, School of Medicine, İstanbul, Turkey. drokocaman@hotmail.com
authors.forename: Orhan
authors.initials: O
authors.lastname: Kocaman
authors.forename: Ahmet
authors.initials: A
authors.lastname: Danalioğlu
authors.forename: Ali Tüzün
authors.initials: AT
authors.lastname: İnce
authors.forename: Mukaddes
authors.initials: M
authors.lastname: Tozlu
authors.forename: Hakan
authors.initials: H
authors.lastname: Şentürk
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D000328:Adult; D000368:Aged; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D010537:Peritoneum / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000473:pathology; D014395:Peritonitis, Tuberculous / Q000000981:diagnostic imaging* / Q000473:pathology*